1. Field of the Invention
The invention relates generally to the fields of autoimmunity and inflammatory bowel disease and more specifically to the development of pouchitis in patients with ulcerative colitis.
2. Background Information
Inflammatory bowel disease (IBD) is the collective term used to describe two gastrointestinal disorders of unknown etiology: Crohn's disease (CD) and ulcerative colitis (UC). The course and prognosis of IBD, which occurs world-wide and is reported to afflict as many as two million people, varies widely. Onset of IBD is predominantly in young adulthood with diarrhea, abdominal pain, and fever the three most common presenting symptoms. The diarrhea may range from mild to severe and in ulcerative colitis often is accompanied by bleeding. Anemia and weight loss are additional common signs of IBD. Ten percent to fifteen percent of all patients with IBD will require surgery over a ten year period. In addition, patients with IBD are at increased risk for the development of intestinal cancer. Reports of an increasing occurrence of psychological problems, including anxiety and depression, are perhaps not surprising symptoms of what is often a debilitating disease that strikes people in the prime of life.
Progress has been made in diagnosing IBD and in distinguishing, in many cases, Crohn's disease from ulcerative colitis. However, CD and UC each can represent a collection of heterogeneous disease types that affect the gastrointestinal tract and produce similar symptoms. One aspect of the heterogeneity associated with inflammatory bowel disease is revealed by the stark contrast in outcomes seen following colectomy for treatment of uncontrolled ulcerative colitis. The preferred procedure is abdominal colectomy with ileal pouch anal anastomosis (IPAA), whereby the diseased colonic mucosa is removed while continence is maintained through creation of an ileal reservoir or "pouch." Although a subgroup of UC patients experience a favorable outcome following surgery, over time as many as 47% develop "pouchitis," which is an inflammation of the pouch that can mimic the original symptoms of UC. A method of determining the subgroup of UC patients at increased risk for development of pouchitis would be useful in the medical management of these patients following surgery. Unfortunately, a method of predicting the development of pouchitis currently is not available. Thus, there is a need to determine the risk of developing pouchitis following pouch surgery. The present invention satisfies this need and provides related advantages as well.